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i 1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evef ettwa.or `'' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: � PROPERTYTN(k qf�tM1T�� .O� <br /> �v� <br /> LEGAL for new consiruction: Short PlaUsubdivisl Lot No._ (attach copy of loig legal description) <br /> OWNER PhonelE-meil <br /> Address CitylSlale2tp <br /> CONTRACTOR 3 L&I L(a# <br /> Address <br /> � PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ` a <br /> PhonelE-meil �"/ .S� — � �S� <br /> BUILDING PERMIT APPLICATION cONrRACT PRICE oF WORK <br /> Existing Use of Buiiding HEAT SOURCE: <br /> Proposed Use of Building Ges_ Electric_ Other_ <br /> Buildingtype: _SingleFamily _Duplex_Townhouse _Multi•Famiiy _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._,Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(eddifional space provided on the back): <br /> Have you started worktng wlthout a permit7 ,_,YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProJect: _Naw_Addn _Alteratlan_Repair TypeotProJeet: _New_Addn _Alteration_Repair <br /> Show Number(p)ol fixtures Show Number(M)01 nxtures <br /> A/C—air handling unils Toilet <br /> Forced air systems Balhtub <br /> Gas piping Lavato (wash basin) <br /> Water healer Shower <br /> Gas fireplace Kitchen sink&disposai <br /> Gas renge Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/badmo /etc.) <br /> Heat pump BackFlow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease lrap <br /> Ducting Roof drains <br /> Olher Medical Gas <br /> SPRINi(LER /SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify ihat I have read and ezamined this application and know the same to be true and cortect.All provisions of laws and ardinances goveming <br /> this type of work will be complied wilh whether specified herein ar not.The granting of a pertnit does not presume lo give authority to violate or cancel <br /> the provisio�her stale or local law regulaling construc(ion or Ihe perlortnance of construction.Thal I am aulhorized by lhe owner of lhis propert� <br /> lo peA he rk for which licalion is made camply wilh Ihe Slate Contractors Law 18.27 RCW and 298.200 WAC <br /> O !horl Agen:Signahre Date (Revisad7RU11) <br />